Home News “They will come at 6am to prepare you.”

“They will come at 6am to prepare you.”

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By: Andrew Loh

“They will come at 6am to prepare you,” the night nurse told me. Mine would be among the first surgeries of the day.

Dinner the night before
Dinner the night before

It was a sense of relief to hear that because it meant I would finally be going through with the surgery, and that there is very little more I need to do. But later, that relief also turned to anxiety and fear, feelings which I knew I would have as the day drew nearer, although at the same time I had also been looking forward to the event.

And the next morning, just like clockwork, the nurses came into my ward and told me, “Mr Loh, we will have to prepare you.”

I looked at the clock and it was 6am.

I hadn’t slept much the night before. I kept running the whole operation through my mind, just to calm myself. I had had some last-minute nervous thoughts.

“Do I realise how major this operation is? What if I don’t make it out as expected? What is going to happen to the lady [my partner] and our two boys? Who is going to look after them?”

Dinner the night before
Dinner the night before

And I also thought of my 80-year old mom, whom I had kept the news of the surgery from. I didn’t want her to worry and see me in a weakened state. It would cause her sleepless nights. I mean, I have never, in all my 50 years, been hospitalised for anything.

These fearful thoughts are natural. After all, someone is going to cut you up in more than one place on your body, open you up, repair your heart, stitch you up and hope you live as a normal person again.

Nothing can go wrong.

But I took comfort and courage in the fact that I had two very good doctors overseeing my case. Cardiologist Dr Jack Tan, who is the deputy head of the Cardiology Department at the National Heart Centre Singapore (NHCS); and Dr Lim See Lim, a senior consultant cardiothoracic surgeon at the same centre.

According to news reports, in 2013, there were some 500 bypass surgeries performed in Singapore. So, it is not something new to us. Our doctors are quite experienced.

At about 7am, they put me on a gurney, asked me to put on my surgery cap, and wheeled me to the ante-room of Operating Theatre 3 (OT 3). Along the way, the nurses would ask me for my name and NRIC (Identity Card) number several times. This is to make sure they have the right patient for surgery. A simple but useful thing to do, for sure!

The trip to OT 3 is quite a long one, from SGH (where I was) to NHCS, and along the way I thought to myself, “Ya, here I am, all by myself, doing this thing.” It was a good thing none of my loved ones were there. I just wanted to get this done as quickly as possible so I can focus on recovery.

I also did not want any of my family or friends to unduly worry.

In what was an extremely cold anteroom the anaesthesiologist hooked me up with catheters, and prepared the various solutions required for the surgery. I wasn’t freaked out by any of it at all. Just have to remind yourself what these are for, and they are for your own good.

After all was done, and several catheters inserted into my arm, I was taken into OT 3.

I was still awake, and felt normal.

Above me I could those big surgical or procedure lights which would soon be turned on when the surgery begins.

A nurse again asks me for my name and NRIC.

Another nurse later told me, “Hi Mr Loh, I am the nurse in charge here. Are you ok?”

Honestly, I was. Quite ok, by this time.

And that was the last thing I remember.

I guess by that time, the general anaesthesia had kicked in and I had fallen into a deep sleep – and would be until 7pm that evening.

2nd day, making best effort to sit on a chair
2nd day, making best effort to sit on a chair

I do not remember a thing at all – not even being sleepy (if I indeed was), or being drowsy. I’d have thought I would feel and be aware of my eyelids closing or struggling to be kept open.

And no, no one asked me to count to 10 either.

It is just as well – you go off to a deep sleep, and the medical team gets to work. Hours later, you awake and it is done.

That was what happened.

Of course, they would later tell me what had gone on – such as how the operation started in fact at about 9am, and ended at almost 1pm; and that I was held in the recovery room for some hours after that, to make sure I was stable after the op, before being transferred to the Intermediate Care Area (ICA), where I would stay for three days, and two days later to the general ward (C Class).

I was not transferred to the Intensive Care Unit (ICU) immediately after the surgery as my vitals were quite stable, I learned later. This is also a reason why the surgeon was able to do an “extra” graft during surgery, making mine a quadruple bypass op rather than a planned triple bypass one.

I am not sure why my vitals were apparently quite good but I would attribute it partly to the healthier and more active lifestyle I have adopted the last few years.

The scars look more nasty in photos than they actually are
The scars look more nasty in photos than they actually are

At the ICA, the first thing I saw upon opening my eyes was my sister’s face. But the effort to open my eyes was a herculean one. I remember barely able to open them at all. My sister probably said something but I have no memory of what it might be.

The lady, in the meantime, had taken the day off and had been busy waiting outside the OT as the surgery took place. She also had to go home at one point to make sure the boys were ok at home after school and to make dinner for them, before returning to see me again in the evening.

At some point, I looked down at my arm and saw that it was bandaged – and then I fell off to sleep again.

And that was the day of the operation.

Did I feel pain?

Open chest surgery is a traumatic and even violent event, and with the heart having to be stopped and the body put into cold storage for an extended period, it is quite frightening for the uninitiated.

Strangely, however, I did not feel much pain.

Scars left after docs took veins from arm to do grafts
Scars left after docs took veins from arm to do grafts

On the day of the operation, I was put on morphine after surgery, but morphine made me uncomfortably nauseous. And throwing up with stitches in your chest is not a very pleasant experience. So, I asked for the drug to be removed.

Doc then prescribed codeine on the second day after the op. But codeine made me extremely drowsy and wanting to sleep all day. So I asked for it to be removed.

Doc then replaced codeine with paracetamol, or popularly known here as “Panadol”.

So, I was on just paracetamol for another two days.

I was without painkiller for the last two days I was in the general ward.

All in all, the pain was comfortably bearable because it was really minimal. I mostly felt pain only when I coughed, or inadvertently added pressure to my chest (which didn’t happen often anyway).

Things went rather well after that first day, with me being transferred to the general ward a mere three days after the surgery itself. My family members were quite surprised by this, and so was I.

5 days after op, I was on my way home
5 days after op, I was on my way home

And then two days after that, I was declared fit for discharge.

I would like to express my admiration and appreciation to all the (medical) staff at the SGH and NHCS involved – from the PRC guy who keep the ward clean so assiduously every morning, to the male and female nurses (both day and night shifts) – with a special shout-out to the Filipino nurses at NHCS who were so patient and caring towards the patients – and the Nanyang Polytechnic interns at the general ward who were so diligent in providing assistance to the patients, and of course to Dr Tan and Dr Lim who have done a world-class job on me.

Now, I have a second lease on life – and you can bet I will be grabbing it with both hands.

Republished from Andrew Loh’s blog with permission.

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